MEDICARE: SAMUEL CHUN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician	MD2003-0409	NM
2	207XS0106X	Orthopaedic Hand Surgery Physician	2003-0409	NM

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	NM009P04	OTHER	NM	BCBS NM
2	10005490	OTHER		LOVELACE
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	2265066	OTHER		CIGNA
5	160999	OTHER		UHC
6	PROVP12469	OTHER		MOLINA
7	201043508	OTHER		PRESBYTERIAN HEALTH PLANS
8	834635	OTHER		CCN

General Provider Information

NPI Number	:	1427026038
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMUEL CHUN MD

Provider Business Mailing Address
First Line	:	455 SAINT MICHAELS DR
Second Line	:	PHYSICIAN PRACTICES, ATTN: CARLA GOMEZ
City	:	SANTA FE
State	:	NM
Zip	:	87505-7601
Country	:	US
Telephone Number	:	505-424-0200
Fax Number	:

Provider Business Practice Location Address
First Line	:	1631 HOSPITAL DR
Second Line	:	SUITE 200
City	:	SANTA FE
State	:	NM
Zip	:	87505-4728
Country	:	US
Telephone Number	:	505-424-0200
Fax Number	:	505-424-6608

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/09/2006
Last Update Date	:	05/31/2011

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Directions to “ SAMUEL CHUN MD” Practice Location

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